Amplify Health

Healthcare

SeniorClaimsOperationsSpecialist

$450–750k ~AI est. Hong Kong, Hong Kong, China FULL TIME
Market Sentiment
HIGH DEMAND

Neural analysis suggests this role is
optimal for Senior candidates.

The Brief

“Senior Claims Operations Specialist at Amplify Health. Skills: Claims operations, Provider management, Process optimisation, Stakeholder engagement. Develop and implement in-market strategy. Identify opportunities to enhance efficiency”

What You'll Achieve.

Enhance operational efficiency; Increase straight-through processing; Reduce manual effort; Enhance adjudication accuracy; Measure value realisation; Optimize value in delivery; Streamline claims workflows; Stay at forefront of innovation; Focus on cost efficiency; Support improvement cycles; Ensure seamless claims operations; Ensure alignment with standards; Ensure alignment with regulations; Foster culture of innovation; Ensure smooth adoption; Close operational gaps; Detect, prevent, mitigate FWA; Continuously refine detection models; Track value delivery; Operationalise provider agreements; Strengthen provider risk mitigation; Capture value

Industry & Context.

Healthcare
Problems you'll solve

Root cause analysis; Data-driven decision making

What They're Looking For.

Must Have

Over 7 years of experience, Experience leading claims transformation, Experience leveraging automation, Familiarity with claims adjudication platforms, Familiarity with FWA detection tools, Familiarity with data-driven operations design

Nice to Have

Prior experience in consulting, Medical degree, Health science MBA, Advanced degree

What You'll Do.

Develop and implement in-market strategy

Identify opportunities to enhance efficiency

Drive initiatives to increase STP

Collaborate to design and deploy solutions

Collaborate to ensure alignment

Work to deploy AI-driven solutions

Oversee integration of analytics tools

Evaluate emerging technologies

Partner with insurtech vendors

Lead transformation of claims processes

Implement best-practice frameworks

Translate business requirements

Engage with regulators

Engage with providers

Collaborate with client stakeholders

Adapt processes and SOPs

Lead organizational change efforts

Provide training and support

Communicate transformation goals

Identify and close operational gaps

Deploy AI-enabled solutions

Collaborate to refine detection models

Recommend enhancements to audit frameworks

Oversee tracking of value delivery

Partner to design and embed solutions

Translate provider requirements

Conduct workflow observations

How You'll Work.

Team & Collaboration

Cross-functional teams; Client stakeholders; Product teams; Technology teams; Data teams; Underwriting teams; Actuarial teams; Provider management teams; Customer service teams; Special Investigation Units; Analytics teams

Communication Scope

Translate business requirements; Communicate transformation goals

Full Job Description

**Do meaningful work with us. Every day.** At Amplify Health, we’re looking for individuals with ambition, resilience and passion for healthcare, insurance, wellness and digital technology. As a fast-growing business with the ambition of making people and communities across Asia healthier, we have exciting career opportunities available to help us achieve our vision. Based in Hong Kong and reporting to the Claims Operations Lead, the Claims Operations Specialist is responsible for implementing Amplify Health’s in‑market strategy for claims operations solutions. The role serves as a critical interface between client relationships, external stakeholders, including providers and regulators, and internal stakeholders to align transformation efforts with industry standards and requirements. Key to success in this role will be the ability act the key conduit between the numerous business stakeholders and technical teams to translate complex business needs into actionable operational, process, and technology solutions for clients. As Claims Operations Specialist, Hong Kong, at Amplify Health you will play a key role in shaping the future of Hong Kong’s claims management process. You will be working with some of the largest healthcare payors in the country, as well as providers and regulators to leave a lasting impact on the industry. **Responsibilities** **Strategy Development & Execution** * Partner with the Claims Operations Lead to develop and implement an in‑market strategy that drives end‑to‑end transformation of claims operations and claims risk management. * Identify opportunities to enhance operational efficiency through organisational redesign, process optimisation, automation, and technology adoption. * Drive initiatives to increase straight-through processing (STP), reduce manual effort, and enhance adjudication accuracy. * Track key KPIs to measure value realisation and operational effectiveness. **Technology and Innovation:****** * Collaborate with AH’s produc

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